OBJECTIVES: To estimate the direct cost components of pulmonary arterial hypertension (PAH) in a Turkish setting. METHODS:  Delphi-technique was used. An expert-panel consisting of members from cardiology, pulmonology and cardiovascular surgery met to discuss the disease management processes in PAH. The global and local-literature and guidelines have been reviewed and local clinical practices questionnaires (separately for functional classes (FC)) have been completed. All cost-components, including medications, surgical treatment, hospitalization, screening and outpatient follow-up procedures were reviewed. February-2016 local prices released by Ministry of Health and Social Security Institution in Turkey were used as references. February-2016 currency rate was used. RESULTS:  The total-costs, excluding disease-specific medications, of PAH/year for patients in FC-II, FC-III and FC-IV were calculated as 576€, 1,005€ and 5,542€, respectively. The corresponding costs of disease-specific medications were 8,864€, 17,920€ and 17,920€ (panel experts noted that disease-specific drugs are given in similar combinations and doses in FC-III and FC-IV). Therefore, the total annual-costs of PAH in FC-II, FC-III and FC-IV were estimated as 9,440€, 18,925€ and 23,462€, respectively. Costs of other components per annum, used in calculating the total-cost in FC-II, FC-III and FC-IV were as follows: follow-up: 101€, 199€ and 1,355€; medications for palliation: 116€, 156€ and 1,867€; non-pharmacologic treatment: 126€, 366€ and 366€; laboratory tests: 232€, 283€ and 1,211€, respectively. Cost of lung-transplantation was found as 742€ in FC-IV (percentage of FC-IV patients assumed to be transplanted “lung” and “heart-lung” is 2.5% and 0.1%, respectively and price of each operation is 28,550€ [28,550x2.5%+28,550x0.1%=742€])